Objective To investigate the factors in association with colorectal disorders in adult recipients of liver allograft. Methods A retrospective cohort study was carried out with clinical, microbiological and management data regarding diarrhea in 218 adult recipients of liver allograft from Jan. 2003 to Dec. 2006. Results Of the 218 patients, 68(31.2%) of them, who did not history of ulcerative colitis, were found to have diarrhea after orthotopic liver transplantation. Among these 68 patients, diarrhea was probably caused by administration of immunosuppressive agents in 35 cases (51.4%), in 12 cases (17.6%) diarrhea was antibiotics associated, and in 5 cases (7.4%) it was due to intraperitoneal infection. The other pathogenic factors included fungal infection in 3 cases (4.4%), cytomegalovirus infection in 3 cases (4.4%), Roux-en-Y choledochojejunostomy in 8 cases (11.8%) and some other unknown problem related in 2 cases (2.9%). Diarrhea occurred soon after transplantation in most cases. Of the 68 patients, the symptom of diarrhea occurred in the first 2 months in 45 cases (66.2%), and in the next 4 months in 23 cases (33.8%), i.e. the symptoms occurred 5-180 days after transplantation. Conclusion Immunosuppressive agents, antibiotics, fungal infection and cytomegalovirus infection are the top four common causes of diarrhea after orthotopic liver transplantation. The outcome is good with appropriate conservative management.

Objective To explore the etiology and clinical prevention regime for hepatitis B virus reinfection in patients after orthotopic liver transplantation. Methods One hundred and twenty eight orthotopic liver transplantation recipients with hepatitis B virus related end-stage liver diseases were analyzed retrospectively. The patients' primary diseases included chronic fulminant hepatitis B, end-stage liver cirrhosis and liver carcinoma. All the patients were given lamivudine pre-transplantation to prevent hepatitis B virus reinfection. Single lamivudine was administered post-transplantation in 3 cases; lamivudine combined with hepatitis B immunoglobulin were given in 125 cases. Adefovir dipivoxil was administered to the patients with hepatitis B virus reinfection. All the patients were followed-up for 3～48 months. Results Two out of the three patients who received single lamivudine developed hepatitis B virus reinfection. The reinfection occurred in one patient 6 months after orthotopic liver transplantation, and the other patient was found to be reinfected 9 months after transplantation. Five out of the 125 patients who received lamivudine and hepatitis B immunoglobulin (small dosage) developed hepatitis B virus reinfection. To 3 patients with hepatitis B virus reinfection adefovir dipivoxil was given, and hepatitis B virus-DNA negative conversion was observed after three months of treatment. Conclusions Treatment with lamivudine and low dose of hepatitis B immunoglobulin post-transplantation may offer an effective prevention against hepatitis B virus reinfection. Adefovir dipivoxil is effective for patients with reinfection of hepatitis B virus by suppressing its variant replication.

Objective To develop a portable and automatic quick screener for noise-induced hearing loss(NIHL),which is suitable for airman and ground crew.Methods Through using audio decoder chip VS1003 to achieve quick screener for noise-induced hearing loss and pre-exposing for special background noise.LPC2148 of ARM7-TDMI configuration was adopted as main controlling chip,and its software design was completed by multitask scheduler based on UCOS-Ⅱ,while the FAT system controlled the read-write to the files in SD card.The signal emergence,change in hearing class,frequency selection as well as records of subject reaction were automatically achieved.Results The system can produce stable signal of exact frequency according to GBZ49-2002 Diagnostic Criteria of Occupational Noise-induced Hearing Loss to output stability of the frequency and intensity of the audio signal,and the specific context of the noise pre-exposure function with screening of hearing impairment was achieved automatically.Conclusion Based on the great power of embedded system and VS1003,the portable and automatic quick screener for noise-induced hearing loss(NIHL) can be developed to carry out many functions,which has several features,such as simple structure,high integration,good stability and use of flexible etc.

Objective To summarize the experiences got from perioperative management for intravital liver transplantation. Methods Of 30 cases of intravital liver transplantation, executed from June 2006 to December 2007 in the General Hospital of PLA, the data of perioperative management were retrospectively analyzed. Among the recipients, 26 received right hepatic lobe including middle hepatic vein (MHV), 2 received right hepatic lobe without MHV, 1 received complementary liver transplantation with MHV in left half liver, and the remained one received right hepatic lobe plus left external lobe including MHV. The primary diseases in the recipients included serious chronic hepatitis (8 cases), primary hepatocarcinoma (9 cases), fulminant hepatic failure (5 cases), final-stage cirrhosis (5 cases), and one each of liver purpura, liver angiosarcoma and Kinnier-Wilson syndrome. On Child-Pugh status, 5 cases in grade A, 9 in grade B and 16 in grade C. The score on the model for end-stage of liver disease (MEHD) was 27.7 (6.8-45.6). The total and right half liver volumes of donors were evaluated by conventional 3-D CT, and well-provided preoperative evaluation was done to both donors and recipients. Results For donors the average length of stay was 11 days (9-15) and average blood loss was 341 ml (160-1200ml), only one donor suffered from intra-operative blood loss of 1200 ml and then received 600 ml of concentrated erythrocytes. No severe complications were found in donors, and all of them recovered finally. The complications occurred in 5 recipients (16.7%), including bile leakage (2 cases), pulmonary infection (2 cases) and one case of diffusive Aspergillus infection. The survival rate of recipients was 90% (27/30), 2 recipients died from severe pulmonary infection and 1 from diffusive Aspergillus infection. Conclusion Sufficient pre-operative assessment for both donors and recipients and exquisite technology are the keys for a successful liver transplantation, and well-provided perioperative managements are also requirements.

Objective To observe the effects of the preconditioning of ulinastatin on GES-1 cell injury induced by oxygen and glucose deprivation (OGD). Methods GES-1 cells were cultured in vitro and divided into three groups: normal control group (group N), oxygen and glucose deprivation group (group O), and ulinastatin preconditioning group (group U). The OGD model of GES-1 cells were established by glucose-free medium and three-gas incubator for 6h. Ulinastatin was added to group U 12h before the deprivation of oxygen and glucose. The cell viability and apoptosis were determined by cck-8 and flow cytometry respectively. Western Blot was used to examine the protein expression of Caspase-3 and Cleaved Caspase-3. The TRPV1 mRNA expression was measured by quantitative real-time PCR. Results As compared with group N, the viability of GES-1 was decreased, the apoptotic rate and the expression of Caspase-3 and Cleaved Caspase-3 were increased, and the TRPV1 mRNA expression decreased greatly in group O (P < 0.05). As compared with group O, the aforementioned changes were significantly inhibited in group U. Conclusions Ulinastatin preconditioning could effectively inhibit GES-1 cell injury induced by OGD, which may be related to the inhibition of apoptosis and the upregulation of TRPV1 mRNA expression.

Objective To investigate the mRNA expression of survivin, livin and XIAP gene in peripheral blood of patients with gastric cancer and its relationship with clinico-pathological features.Methods This study included 50 patients with gastric cancer and 20 healthy donors. The expression of survivin, livin and XIAP gene was detected by reverse transcription-quantitative polymerase chain reaction (RT-QPCR) using a molecular beacon probe, while recombination plasmid containing the sequence of survivin, livin and XIAP was standard. The relationship between copies of survivin, livin and XIAP gene expression in peripheral blood with gastric cancer and clinical data was analyzed. Results A linear standard curve was obtained between 103 ～ 1010 copies. The copies of survivin, livin and XIAP mRNA in peripheral blood of patients with gastric cancer did not correlate with gender, age, and histological types ( P ＞ 0.05). There were positive relationships between copies of survivin, livin and XIAP gene with lymph node metastasis and TNM stage (P ＜0.05 ). The expression of survivine, livin and XIAP was all negative in peripheral blood of healthy people. 52% (17/33) of patients suffered from recurrence or metastasis who had positive expression of survivin and/or livin and/or XIAP mRNA, while it was 18% (3/17)among the negative survivin and/or livin and/or XIAP mRNA caces ( P ＜ 0.05). Conclusions The expression of survivin, livin and XIAP mRNA can be used to detecte micro-metastasis in peripheral blood circulation of gastric cancer.

Objective To investigate the relationship between the gene polymorphism of TLR3c.1377,TLR9-1486,and TLR9 2848 and susceptibility to multiple sclerosis(MS)in Han people of south China. Methods A total of 123 unrelated MS patients from South China with a clinical or laboratory definition MS according to 2005 Revisions to the McDonald Criteria were studied. Another 126 controls were randomly selected from hospital staff of non-autoimmune diseases and healthy individuals. Toll like receptor (TLR) 3 and TLR 9 genotypes were determined by PCR and digested by specific restriction enzymes.Results There was significant difference in genotype and allele distribution of TLR3c.1377 polymorphism between the MS patients and the controls (P<0.05), and the MS patients with T allele had a lower risk (OR=0.532, P=0.014). There was no significant difference in genotypes and allele distribution of TLR9-1486 polymorphism between the MS patients and the controls. There was higher TLR9 2848 A allele frequency in the MS patients than in the controls ((39.8%) vs. 30.6%;P=0.037), and higher risk in MS patients with A allele than those without ((OR=)(1.837), P=0.020). There was no significant interaction among the TLR3c.1377, TLR9-1486 and TLR9 2848 allele. Strong linkage disequilibrium was found between TLR9-1486 and TLR9 2848, but there was no significant interaction between the polymorphism of TLR9-1486 and TLR9 2848 in the MS patients.Conclusion TLR3c.1377 and TLR9 2848 polymorphisms may be related to MS in Han people in south China. TLR3c.1377 and TLR9 2848 may be linked with susceptibility genes.

Objective To investigate the influence of hepatectomy combined with splenectomy on curative effect of primary hepatocellular carcinoma patients associated with hypersplenism.Methods Twenty three cases of primary hepatocellular carcinoma associated with hypersplenism were analyzed retrospectively and divided into hepatectomy combined with splenectomy group (n=10) and hepatectomy combined with ligation of splenic artery (n=13). Peripheral blood samples were collected 1 week before operation and 3 monthes after operation respectively. The levels of CD4, CD8, CD16, CD4/CD8, WBC and PLT in the blood were detected. Survival rate between the two groups was compared. Results There were not significant differences in the expressional levels of CD4, CD8, CD16, CD4/CD8,WBC and PLT before operation, bleeding quantity during the operation and rate of severe complications after operation in the two groups. The expressional levels of CD4, CD16, CD4/CD8, WBC and PLT of hepatectomy combined with splenectomy group were much higher in 3 months after operation than those in 1 week before operation and in hepatectomy combined with ligation of splenic artery group (P

Hypoxia-inducible factor(HIF) is an important transcript factor in sensing the concentration of O2 in cell and regulating the adaptation to hypoxia.HIF is consist of two subunits called ? and ? with ? as an oxygen-sensitive unit and ? as a constitutively expressed unit.The activity of HIF is regulated by both pVHL/proteasomal destruction system and non pVHL/proteasomal destruction system.Because the brain is the most oxygen-sensitive organ,use of HIF may be a potential application in treating cerebral ischemia disease.Yet HIF is reported to have both neuroprotective and proapoptotic functions in cerebral ischemia,which makes the application of HIF more complicated.This review will discuss the possible function and mechanism of HIF in cerebral ischemia,and the possible application of HIF to clinic.

Objective Corneal endothelial decompensation is caused by many corneal diseases. It often results in severe clinical complications. Endothelial keratoplasty (EK) is a new therapy for corneal endothelial decompensation. This study aimed to investigate a new approach to establishing corneal endothelial decompensation animal model with Descemetorhexis technique in order to better understand the tissue response to EK. Methods Thirty New Zealand white rabbits were randomly divided into three groups according to different surgical procedures; corneal endothelial cells (CEC), Descemet's membrane and corneal endothelial cells (DM + CEC) as well as Descemet' s stripping with endothelial keratoplasty(DSEK) group and 10 eyes for each. The right eyes of rabbits were as surgery eyes. Other 10 rabbits were as DSEK donors. Corneal transparency, anterior chamber response and graft location were examined once per day for two weeks under the slit lamp. Comeal thickness was measured by ultrasound biomicroscope. Corneal endothelial cells were analyzed using vital staining with alizarin red and trypan blue in 2, 4 and 8 weeks after operation. Results The cornea in DM + CEC group remained opaque throughout the observation period. In CEC and DSEK group, corneal clarity was gradually restored and corneal thickness was significantly less than that in the DM + CEC group during the postoperative 8 weeks. There were significant differences in corneal thickness between the DM + CEC group and CEC group or DSEK group during the postoperative 8 weeks (P ＜0. 05). The vital staining showed that most Descemetorhexis area was not covered by endothelial cells even 2 months after surgery. Conclusion A new corneal endothelial decompensation model is successfully established for the study of corneal endothelial keratoplasty, which is helpful for understanding the wound-healing of rabbit corneal endothelium after Descemel' s membrane damage.